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Requests for Non-Disclosure of Poor Prognoses to Patients
  1. Kristina Reynolds, Hospice and End-of-Life Care Registered Nurse
  1. Terre Haute, IN, and Masters of Science in Nursing Graduate Student, Indiana Wesleyan University, Marion, IN. Email: kristina.reynolds{at}myemail.indwes.edu

Abstract

For patients who are given information about a life-limiting diagnosis and poor prognosis, it can be very distressing to hear words such as ‘terminal’ and ‘end of life’. These words are also upsetting for patients’ family members/loved ones. In some instances, the family or surrogate decision-makers may ask that health professionals withhold the prognosis and distressing terminology by requesting non-disclosure of this health information to their loved one. These types of situations can be stressful to the healthcare professional and ethically problematic. Healthcare professionals may feel torn between doing what they perceive as being in the best interests of the patient and complying with the family’s request for non-disclosure. This article explores the distress that being told about terminal prognoses causes patients and family members/loved ones and highlights some of the reasons for families requesting non-disclosure of terminal diagnosis. Cultural considerations for such requests, effects of non-disclosure on patients and ways in which to resolve the conflict are also discussed. Conflicts of interest: none

  • Autonomy
  • Breaking bad news
  • Communication skills
  • End-of-life care
  • Non-disclosure
  • Terminal prognosis

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